Provider Demographics
NPI:1093488660
Name:FAMILY SERVICE & CHILDREN'S AID SOCIETY OF VENANGO COUNTY
Entity Type:Organization
Organization Name:FAMILY SERVICE & CHILDREN'S AID SOCIETY OF VENANGO COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SERAFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-677-4005
Mailing Address - Street 1:716 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301-2330
Mailing Address - Country:US
Mailing Address - Phone:814-677-4005
Mailing Address - Fax:
Practice Address - Street 1:10 LYNCH BLVD
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-2106
Practice Address - Country:US
Practice Address - Phone:814-677-4005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA451600OtherDEPARTMENT OF HUMAN SERVICES
PA100001637Medicaid